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Dr K K Aggarwal

In Paralysis, Act Fast

By Dr K K Aggarwal
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Brain attack should be tackled like a heart attack. As time is brain, a patient with suspected paralysis/stroke or brain attack should be shifted to hospital at the earliest and given a clot dissolving therapy if the CT scan is negative for brain hemorrhage. Prevention for paralysis is the same as prevention for heart attack. All patients with paralysis should be investigated for underlying heart disease and all patients with heart diseases should undergo testing to detect blockages in the neck artery, which can cause future paralysis.

Facts

  • Brain haemorrhage should be ruled out as soon as possible.
  • Obtain emergent brain imaging (with CT or MRI) and other important laboratory studies, including cardiac monitoring during the first 24 hours after the onset of ischemic stroke.
  • Check glucose and correct high or low sugar. If the blood sugar is over 180 mg/dL, start insulin.
  • Maintain normothermia for at least the first several days after an acute stroke.
  • For patients with acute ischemic stroke who are not treated with thrombolytic therapy, treat high blood pressure only if the hypertension is extreme (systolic blood pressure >220 mmHg or diastolic blood pressure >120 mmHg), or if the patient has another clear indication (active ischemic coronary disease, heart failure, aortic dissection, hypertensive encephalopathy, acute renal failure, or pre–eclampsia/eclampsia).
  • For patients with acute ischemic stroke who will receive thrombolytic therapy, antihypertensive treatment is recommended so that systolic blood pressure is 185 mmHg and diastolic blood pressure is 110 mmHg.
  • Antithrombotic therapy should be initiated within 48 hours of stroke onset.
  • For patients receiving statin therapy prior to stroke onset, it should be continued.

In an audience based interaction on paralysis, Padmashri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India,  Dr. Vinit Suri, Senior Neurologist, Apollo Hospital and Dr. Vibha Sharma, Ayurvedic Consultant said that brain attach should be tackled like a heart attack. As time is brain, a patient with suspected paralysis/stroke or brain attack should be shifted to hospital at the earliest and given a clot dissolving therapy if the CT scan is negative for brain hemorrhage.  Prevention for paralysis is the same as prevention for heart attack.

All patients with paralysis should undergo testing for underlying heart disease and all patients with heart diseases should undergo testing to detect blockages in the neck artery which can cause future paralysis.

The programme was organized as part of 19th MTNL Perfect Health Mela celebrations which will open to general public on 7th November, 2012 at Constitution Club of India and will be a mix of exhibitions, competitions, workshops, seminars, entertainment incorporating all pathies under one roof. The entry to the mela will be free. The programme will have a telecast in DD India.

 Facts

1.    One should rule out brain hemorrhage as soon as possible

2.    Obtain emergent brain imaging (with CT or MRI) and other important laboratory studies, including cardiac monitoring during the first 24 hours after the onset of ischemic stroke

3.    Check glucose and correct high or low sugar. If the blood sugar is over 180 mg/dL start insulin

4.    Maintain normothermia for at least the first several days after an acute stroke

5.    For patients with acute ischemic stroke who are not treated with thrombolytic therapy, treat high blood pressure only if the hypertension is extreme (systolic blood pressure >220 mmHg or diastolic blood pressure >120 mmHg), or if the patient has another clear indication (active ischemic coronary disease, heart failure, aortic dissection, hypertensive encephalopathy, acute renal failure, or pre-eclampsia/eclampsia)

6.  For patients with acute ischemic stroke who will receive thrombolytic therapy, antihypertensive treatment is recommended so that systolic blood pressure is ≤185 mmHg and diastolic blood pressure is ≤110 mmHg

7. Antithrombotic therapy should be initiated within 48 hours of stroke onset.

8. For patients receiving statin therapy prior to stroke onset it should be continued

 Breast Cancer is on the rise

In another discussion organized by the Heart Care Foundation of India, Dr. KK Aggarwal, President of the Foundation, Dr. P.K. Julka, Senior Cancer Specialist, AIIMS and Dr. Anurag Srivastava, Breast Cancer Surgeon, in a joint statement said that breast cancer is on the rise in the country. The doctors said that breast cancer, prostate cancer and heart diseases are all linked to obesity, eating refined carbohydrates, smoking and access of alcohol.

They said that eating vegetarian diet with large amount of fruits and vegetables, exercising regularly and no smoking and drinking in moderation can reduce the chances of breast cancer.

a. Globally, breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in females.

b. Risk factors have been associated with female breast cancer  are Age and gender; Race and ethnicity; Benign breast disease; Personal history of breast cancer; Lifestyle and dietary factors; Reproductive and hormonal factors; Family history and genetic factors; Exposure to ionizing radiation; Environmental factors and Smoking

c.  Men are more than one hundred times less likely to get breast cancer than women.

d.  Women can take to decrease their risk of breast cancer. These include lifestyle changes: minimize use of postmenopausal hormones, childbearing at a younger age, breastfeeding for at least six months, avoidance of adult weight gain, limiting alcohol consumption, avoidance of smoking, regular physical activity), chemoprevention and early detection through screening mammography.

e.  Breast cancer is the most common female cancer

f.   It is second most common cause of cancer death in women

g.  It is main cause of death in women ages 40 to 59.

h. Important risk factors for breast cancer are age, gender, hormonal factors, and family history.

i. The diagnostic evaluation of a patient with suspected breast cancer includes diagnostic breast imaging and breast biopsy.

j. All primary breast cancers should be evaluated for expression of hormone receptors (estrogen [ER] and progesterone [PR] receptors) and human epidermal growth factor receptor 2 (HER2) expression.

k.    The treatment of early breast cancer includes locoregional treatment with surgery, radiation therapy, or both, and the treatment of systemic disease with one or a combination of chemotherapy, endocrine therapy, or biologic therapy.

l.  Many women have the option of preserving a cosmetically acceptable breast with breast conserving therapy (BCT) without sacrificing survival.